Soft tissue fixation system

ABSTRACT

A soft tissue fixation assembly includes a plurality of deformable bone anchors and a suture that is configured to fixedly attach to each of the bone anchors. One or more of the bone anchors can be inserted into a bone, and one or more of the bone anchors can be inserted through soft tissue and into the bone. The suture can be inserted through the bone anchors, and energy can be applied to the anchors, thereby causing a deformable material of the bone anchors to deform, thereby capturing the strand of suture in the bone anchor. The strand of suture can be placed in tension, and can extend over the soft tissue so as to retain the soft tissue in contact with the bone.

CROSS-REFERENCE TO RELATED APPLICATIONS

This is a continuation of U.S. patent application Ser. No. 13/832,201,filed Mar. 15, 2013, which is a continuation-in-part of U.S. patentapplication Ser. No. 13/800,868, filed Mar. 13, 2013, the disclosures ofboth of which are hereby incorporated by reference as if set forth intheir entirety herein. This claims the benefit of U.S. patentapplication Ser. No. 61/780,077 filed Mar. 13, 2013, the disclosure ofwhich is hereby incorporated by reference as if set forth in itsentirety herein.

BACKGROUND

Common injuries can involve tears of soft tissue, such as tendons andligaments, and detachments of soft tissue from one or more underlyingbones. As one example, the tendons at the ends of the rotator cuffmuscles can become torn, leading to pain and restricted movement of themusculoskeletal system. The soft tissue can be conventionallyre-attached to bone arthroscopically, for instance by driving boneanchors into the bone at a desired locations, and attaching separatestrands of suture to each of the bone anchors and the soft tissue. Eachof the separate strands of suture is then tied off to draw the softtissue against the bone, thereby allowing reattachment of the softtissue to the bone.

What is desired is an improved method and apparatus for attaching softtissue to bone.

SUMMARY

In accordance with one embodiment, a bone anchor includes a bone anchorbody defining a proximal end, a distal end that is spaced from theproximal end along a longitudinal axis, and a perimeter that extendsbetween the proximal end and the distal end. The bone anchor body isconfigured to receive a strand of suture. At least a portion of the boneanchor body comprises a deformation material that is responsive to anapplied energy so as to deform and, when the strand of suture isreceived by the anchor body, capture the strand of suture with respectto movement relative to the bone anchor body.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing summary, as well as the following detailed description ofan example embodiment of the application, will be better understood whenread in conjunction with the appended drawings, in which there is shownin the drawings example embodiments for the purposes of illustration. Itshould be understood, however, that the application is not limited tothe precise arrangements and instrumentalities shown. In the drawings:

FIG. 1 is a schematic top plan view of a soft tissue fixation assemblyanchored to bone and retaining a soft tissue against the bone, the softtissue fixation assembly constructed in accordance with one embodiment.

FIG. 2A is a perspective view of a bone anchor of the soft tissuefixation assembly illustrated in FIG. 1, showing the bone anchor inaccordance with one embodiment;

FIG. 2B is a side elevation view of the bone anchor illustrated in FIG.2A;

FIG. 2C is a sectional side elevation view of the bone anchorillustrated in FIG. 2A;

FIG. 2D is a bottom plan view of the bone anchor illustrated in FIG. 2A;

FIG. 2E is a top plan view of the bone anchor illustrated in FIG. 2A;

FIG. 3A is a perspective view of a bone anchor constructed in accordancewith an alternative embodiment;

FIG. 3B is a sectional side elevation view of the bone anchorillustrated in FIG. 3A;

FIG. 3C is an exploded perspective view of the bone anchor illustratedin FIG. 3A;

FIG. 4A is a perspective view of a suture extending through opposedchannels of the bone fixation element illustrated in FIG. 2A;

FIG. 4B is a perspective view of a suture extending through adjacentchannels of the bone fixation element illustrated in FIG. 2A;

FIG. 5A is a schematic sectional side elevation view of a soft tissuefixation system constructed, including an actuation assembly shownoperably engaged with an initial bone anchor of the soft tissue fixationassembly illustrated in FIG. 1;

FIG. 5B is a schematic sectional side elevation view of the soft tissuefixation system illustrated in FIG. 5A, shown after activation of theactuation assembly;

FIG. 5C is a schematic side elevation view of a soft tissue fixationsystem illustrated in FIG. 5B, showing the actuation assembly operablyengaged with a subsequent bone anchor of the soft tissue fixationassembly illustrated in FIG. 1;

FIG. 5D is a schematic sectional side elevation view of the soft tissuefixation system illustrated in FIG. 5C, shown after activation of theactuation assembly;

FIG. 6A is a schematic sectional side elevation view of a portion of thebone fixation assembly 1, showing a single strand of suture sequentiallyconnected continuously to a plurality of the bone anchors;

FIG. 6B is a schematic sectional side elevation view of a portion of thebone fixation assembly 1, showing a pair of strands of suture eachsequentially connected continuously to a plurality of the bone anchors;

FIG. 6C is a schematic sectional side elevation view of a portion of thebone fixation assembly 1, showing the pair of strands of suture eachsequentially connected continuously to a plurality of the bone anchors,one of the strands of suture configured to attach to an auxiliaryimplant;

FIG. 7A is a schematic plan view of the soft tissue fixation assembly asillustrated in FIG. 1, but showing the bone anchors in one arrangement;

FIG. 7B is a schematic plan view of the soft tissue fixation assembly asillustrated in FIG. 7A, but showing the bone anchors in anotherarrangement as illustrated in FIG. 1, shown as an open arrangement;

FIG. 7C is a schematic plan view of the soft tissue fixation assembly asillustrated in FIG. 7B, but showing the bone anchors in a closedarrangement in accordance with one embodiment;

FIG. 7D is a schematic plan view of the soft tissue fixation assembly asillustrated in FIG. 7C, but showing the bone anchors in a closedarrangement in accordance with another embodiment; and

FIG. 7E is a schematic plan view of the soft tissue fixation assembly asillustrated in FIG. 7B, but showing the bone anchors in an openarrangement in accordance with another embodiment.

DETAILED DESCRIPTION

Referring initially to FIGS. 1 and 8B, a soft tissue fixation assembly20 is configured to secure a soft tissue 22 against a surface of anunderlying bone 24 so as to promote attachment of the soft tissue 22 tothe bone 24. The soft tissue 22 can be detached from the bone due to ananatomical defect, trauma, or the like, and can be configured as anyanatomical soft tissue in the human or other animal body, such as atendon or ligament. For instance, in accordance with one embodiment, thetendon can be a rotator cuff tendon or any other tendon as desired.

The fixation assembly 20 can include at least one bone anchor 26, suchas first and second bone anchors 26 a and 26 b, respectively, and astrand of suture 28 that is configured to attach to each of the boneanchors 26 a and 26 b. For instance, the strand of suture 28 isconfigured to be received by each of the bone anchors 26 and 26 b. Thefirst bone and second bone anchors 26 a and 26 b can, for instance, bedriven into the bone 24, such that the strand of suture 28 extends fromthe first bone anchor 26 a to the second bone anchor 26 b. One of thefirst and second bone anchors 26 a and 26 b, for instance the secondbone anchor 26 b as illustrated, can be driven through the soft tissue22 and into the bone 24, referred to as a trans-tendon technique. Theother of the first and second bone anchors 26 a and 26 b, for instancethe first one anchor 26 a as illustrated, can be driven into the bone 24at a location spaced from the soft tissue 22. Thus, the strand of suture28 can extend from the first bone anchor 26 a along an outer surface ofthe bone 24, across an interface 30 between the bone 24 and the softtissue 22, to the second bone anchor 26 b. The strand of suture 28 canbe under tension between the first and second bone anchors 26 a and 26 bso as to apply a force against the soft tissue soft 22 toward the bone24, thereby causing the soft tissue 22 to maintain contact with the bone24. It should be recognized that in most instances it may not berecommended, during rotator cuff repair, to insert the bone anchors 26in the intraarticular space of the shoulder, but rather to position thebone anchors about the joint.

It will be appreciated from the description below that the fixationassembly 20 can include any number of bone anchors 26, such as aplurality of bone anchors 26, as desired. One or more of the pluralityof bone anchors 26 can be driven through the soft tissue 22 and into thebone 24. One or more others of the plurality of bone anchors can bedriven into the bone 24 at a location spaced from the soft tissue 22, soas to define any geometric pattern as desired. In accordance with oneembodiment as illustrated in FIG. 1, the soft tissue fixation assembly20 can include a third bone anchor 26 a driven through the soft tissue22 and the bone 24, and a fourth bone anchor 26 d driven through thebone 24 at a location spaced from both the soft tissue 22 and the firstbone anchor 26 a. The strand of suture 28 can extend continuously fromeach of the plurality of bone anchors 26 to at least one adjacent one ofthe plurality of bone anchors 26. Thus, the plurality of bone anchors 26can define at least one row 32, such as a first row 32 a that can bedefined by at least some of the plurality of bone anchors 26, and asecond row 32 b that can be defined by at least others of the pluralityof bone anchors 26, the strand of suture 28 connected between the firstand second rows 32 a and 32 b. The rows 32 a and 32 b can extendsubstantially linearly, curvilinearly, or can define any other suitablearrangement, and can be parallel with each other or aligned to intersecteach other as desired. The fixation assembly 20 can define as many rowsas desired.

Referring now to FIGS. 2A-2E, each of the bone anchors 26 can include ananchor body 34 that defines a proximal end 36 a and a distal end 36 bthat is spaced from the proximal end 36 a along a distal direction ofinsertion into bone. It should be appreciated that the term “distal” andderivatives thereof can refer to a direction from the proximal end 36 ato the distal end 36 b, and the term “proximal” and derivatives thereofcan refer to a direction from the distal end 36 b to the proximal end 36a. The anchor body 34 can extend, for instance can be elongate, along alongitudinal axis 38, such that the proximal end 36 and distal end 36 bare spaced from each other along the longitudinal axis 38. Thelongitudinal axis 38 can be substantially straight, or can be curved orassume any alternative shape as desired. The anchor body 34 can furtherdefine an outer perimeter 40 extends between the proximal end 36 a andthe distal end 36 b. The perimeter 40 can be round, for instancesubstantially circular, as illustrated, or can define any alternativeshape whatsoever, such as a rectilinear shape. The distal end 36 b candefine a tip 37 that can be tapered inwardly, and thus toward thelongitudinal axis 38, as it extends along the distal direction.

The anchor body 34 can further define at least one channel 42, such as aplurality of (e.g., at least two) channels 42, that extend into theperimeter 40, for instance toward the longitudinal axis 38. Each of thechannels 42 can be configured to receive the strand of suture 28 (seeFIGS. 4A-B). For instance, respective ones of the channels 42 areconfigured to receive respective portions of the strand of suture 28.Each channel 42 can define a central axis 43 a, and a first or proximalend 43 b, and a second or distal end 43 c that is spaced from theproximal end 43 b along the central axis 43 a. The channels 42 canextend along an entirety of the length of the anchor body 34 from theproximal end 36 a to the distal end 36 b, or can extend along a portionof the length of the anchor body 34. Thus, it can be said that thechannels 42 can extend between the proximal and distal ends 43 b and 43c, respectively, for instance from the proximal end 43 b to the distalend 43 c. The channels 42 can, for instance, be open to a proximal-mostouter surface 54 of the anchor body 34, the proximal-most outer surface54 extending from the outer perimeter 40 toward the longitudinal axis38. The central axis 43 a can extend parallel to the longitudinal axis38, or can be angularly offset with respect to the longitudinal axis 38,and can define any shape as desired. The anchor body 34 can include anynumber of channels 42, such as a first channel 42 a and a second channel42 b, that can be disposed on opposite sides with respect to thelongitudinal axis 38, and thus be opposite each other with respect tothe longitudinal axis 38, or can be angularly offset with respect to thelongitudinal axis 38 at any angle of separation as desired.

Thus, a first line 35 a perpendicular to the longitudinal axis 38 thatintersects both the longitudinal axis 38 and the central axis 43 a ofthe first channel 42 a can define the angle of separation with respectto a second line 35 b that is perpendicular to the longitudinal axis 38and intersects both the longitudinal axis 38 and the central axis 43 aof the second channel 42 b. The angle of separation al can besubstantially 180 degrees, or any angle between zero and 180 degrees. Inaccordance with the illustrated embodiment, the anchor body 34 caninclude a third channel 42 c and a fourth channel 42 d that can definean angle of separation with respect to each other, for instance 180degrees as described above with respect to the first and second channels42 a and 42 b. Further, the channels 42 can be equidistantly spaced fromeach other about the perimeter 40 as illustrated, or can be variablyspaced from each other about the perimeter 40 as desired. Thus, adjacentones of the channels 42, such as the first channel 42 a and either orboth of the third and fourth channels 43 c and 43 d, respectively, candefine an angle of separation α2 of substantially 90 degrees. Thechannels 42 that are spaced from each other by an angle of separationthat is greater than 90 degrees and less than or equal to 180 degreescan be referred to as opposed channels. The channels 42 that are spacedfrom each other by an angle of separation that is greater than between 0degrees and less than or equal to 90 degrees can be referred to asadjacent channels.

As will be appreciated from the description below, at least a portion upto all of the anchor body 34 can be made from a deformation material 44,which can be polymeric, that comprises a deformation material responsiveto an applied energy that causes the deformation material, and thus theanchor body 34 at the deformation material, to deform. The appliedenergy can be a laser or any suitable alternative energy, such as anelectrical current,. In accordance with one embodiment, the deformationmaterial 44 can define at least a portion of the anchor body 34,including at least a portion up to an entirety of one or more up to allof the channels 42. For instance, the deformation material 44 can belocated in a region as illustrated in FIGS. 3A-C that can be spaced fromone or both of the proximal end 36 a and the distal end 36 b.Alternatively, the deformation material 44 can comprise an entirety ofthe anchor body 34, from the proximal end 36 a to the distal end 36 b,as illustrated in FIGS. 2A-2E. The deformation material 44 can beresponsive to the applied energy so as to deform at least a portion ofthe anchor body 34 and capture the received portion of the strand ofsuture 28 therein with respect to movement relative to the anchor body34. Deformation of the deformation material 44 in response to theapplied energy can further cause the anchor body 34 to similarly deformand become fixed to the bone 24. In accordance with one embodiment, thedeformation that causes the anchor body 34 to become fixed to the bonecan similarly cause the anchor body 34 to capture the received portionof the suture strand 28 therein with respect to movement relative to theanchor body 34.

For instance, in accordance with one embodiment, the deformationmaterial 44 is configured to deform in response to the applied energyand close at least a portion of each of the channels 42 and capture therespective received portion of the strand of suture 28 in the channels42 with respect to movement relative to the anchor body 34. Deformationof the deformation material 44 in response to the applied energy canfurther cause the anchor body 34 to similarly deform and become fixed tothe bone 24. In accordance with one embodiment, the deformation thatcauses the anchor body 34 to become fixed to the bone can similarlycause the channels 42 to close and capture the received strand of suture28 therein. In accordance with one embodiment, the deformation material44 can be disposed in a middle region of the anchor body 34 that isspaced from the proximal end 36 a and the distal end 36 b. For instance,the middle region can include a location that is disposed midway betweenthe proximal end 36 a and the distal ends 36 b. The bone anchor body 34can be constructed so as to prevent the applied energy from traveling tothe distal end 36 b. For instance, the bone anchor body 34 can defineany color as desired, or be made of any one or more suitable materialsas desired, that can prevent the applied energy from traveling to atleast one select region of the bone anchor body 45, such as the distalend 36 b. Examples of deformation materials of the type described hereinare disclosed in U.S. Patent Application Publication No. 2010/0241229A1, published Sep. 23, 2010, and U.S. Patent Application Publication No.2012/0129131 A1, published May 24, 2012, the disclosure of each of whichis incorporated by reference as if set forth in its entirety herein.

As described above, each of the channels 42 can define a central axis 43a, and a first or proximal end 43 b, and a second or distal end 43 cthat is spaced from the proximal end 43 b along the central axis 43 a.In accordance with one embodiment, the distal ends 43 c of the channels42 can be open to each other, such that the strand of suture 28 canextend distally along one of the channels 42 out the distal end 43 c ofthe channel, into the distal end 43 c of another one of the channels 42and proximally along the other one of the channels 42. For instance, thedistal ends 43 c of the channels 42 can be open to each other at thedistal end 36 b of the anchor body 34. In accordance with oneembodiment, the anchor body 34 can define a void 46 that extends alongthe proximal direction into the tip 37. The void 46 can be aligned withthe longitudinal axis 38, and can be open to the distal ends 43 c ofeach of the channels 42, including the first channel 42 a, the secondchannel 42 b, the third channel 42 c, and the fourth channel 42 d. Whilethe void 46 is open through the tip 37 along the distal direction asillustrated, it should be appreciated that the tip 37 can alternativelybe enclosed, such that the tip 37 defines a distal boundary of the void46. Nevertheless, the void 46 can be open to the outer perimeter 40 andto each of the distal ends 43 c of the channels 42.

Thus, the distal ends 43 c of each of the third and fourth channels 42 cand 42 d are open to both each other and the distal ends 43 c of thefirst and second channels 42 a and 42 b, for instance at the distal end36 b. Similarly, the distal ends 43 c of each of the first and secondchannels 42 a and 42 b are open to both each other and the distal ends43 c of the third and fourth channels 42 c and 42 d, for instance at thedistal end 36 b. For instance, the distal ends 43 c can be open to eachother via the void 46, such that strands of suture extending from thedistal end 43 c of one of the channels 42 to the distal end 43 c ofanother one of the channels 42 can extend across the void 46.Alternatively, the distal ends 43 c of one or more up to all of thechannels 42 can be continuous with each other.

Each channel 42 can be defined by at least one wall that can define abase 45 a of the anchor body 34 and opposed side walls 45 b of theanchor body 34 that extend from the base 45 a toward, for instance to,the perimeter 40. The void 46 can be at least partially defined by afloor 51 that extends toward the perimeter 40, and the anchor body 34can define respective interface 49 between the bases 45 a and the floor51. The interface 49 can be beveled as desired.

With continuing reference to FIGS. 2A-E, the anchor 26 can define aninsertion aperture 52 that extends into the anchor body 34 and isconfigured to receive an energy emitting instrument 70 (see FIG. 6A)that is configured to apply the energy that causes the deformationmaterial 44 to deform as described herein. For instance, the anchor body34 can define the insertion aperture 52 that extends into the proximalend 36 a, and in particular the proximal-most surface 54, substantiallyalong the distal direction. For instance, the insertion aperture 52 canbe centrally disposed with respect to the outer perimeter and thelongitudinal axis 38, and thus can extend substantially along thelongitudinal axis 38. As will be described in more detail below, theinsertion aperture 52 can be sized to receive an energy emittinginstrument 70 (see FIG. 5A) that is configured to apply the energy thatcauses the deformation material 44 to deform in the manner describedherein. The insertion aperture 52 can be round, such as cylindrical, inshape, or can define any suitable alternative shape as desired. Theinsertion aperture 52 can be defined by a base 53 a of the anchor body34 and at least one inner side wall 53 b that can extend from the base53 a along the proximal direction, for instance to the proximal outersurface 54 of the proximal end 36 a. In accordance with one embodiment,the proximal end 36 a that defines the insertion aperture 52 can beintegral and monolithic with one or more up to all of the distal end 36b, the base 45 a of one or more up to all of the channels 42, the sidewalls 45 b of one or more up to all of the channels 42, the floor 51,and the interfaces 49.

Alternatively, as illustrated in FIGS. 3A-C, the bone anchor can includean insert 56 that defines an insert body 59 having a proximal end 56 a,a distal end 56 b spaced from the proximal end 56 a along the distaldirection, and an outer perimeter 56 c that extends from the proximalend 56 a to the distal end 56 b. The insert 56 can define the insertionaperture 52 that is configured to receive the energy emitting instrument70 (see FIG. 6A) that is configured to apply the energy to thedeformation material 44. The bone anchor 26 can define an aperture 60that extends into the anchor body 34 and is sized and configured toreceive the insert 56. For instance, the body 34 can define the aperture60 that extends into the proximal end 36 a substantially along thedistal direction. For instance, the insertion aperture 60 can becentrally disposed with respect to the outer perimeter and thelongitudinal axis 38, and thus can extend substantially along thelongitudinal axis 38. The insert 56 can be insertable in the aperture 60in any manner as desired. For instance, the perimeter 56 c of the insert56 can define a cross-sectional dimension substantially equal to that ofthe aperture 60, such that the insert 56 can be press-fit into theaperture 60. Alternatively, the insert 56 can be secured to the anchorbody 34 in the aperture 60 using any known adhesive, fastener, or thelike. The insert 56 can define a head 61 that extends out from theproximal end 56 a of the body 59 and is configured to abut the proximalmost surface 54. The head 61 can define channels 57 that are alignedwith the channels 42 and extend through the head 61 along the distaldirection. Thus, the channels 42 and 57 can combine to define therespective channels that are configured to receive the strands of suture28 as described herein. The insert 56 can be made from a materialdifferent than the deformation material, such that the insert 56 doesnot deform in response to application of the energy.

Referring now to FIG. 5A, a soft tissue fixation system 62 can includean actuation assembly 64 and the soft tissue fixation assembly 20. Thesoft tissue fixation assembly 20 can include at least one bone anchor,such as a plurality (such as a pair or more) of bone anchors 26 and atleast one strand of suture 28. The actuation assembly 64 can include theenergy emitting instrument 70 and a tensioner 72 that supports theenergy emitting instrument 70. The energy emitting instrument 70 isconfigured to apply energy to the anchor body 34, thereby causing thedeformation material 44 to deform. As the deformation material 44deforms, the tensioner 72 can maintain tension in the suture 28.

The energy emitting instrument 70 can include an energy source 74 and anenergy conduit 76 that extends from the energy source 74 and isconfigured to be inserted into the insertion aperture 52 so as to beconfigured to apply energy to the implant body 34 in sufficient quantitythat the deformation material 44 deforms in response to the appliedenergy, or can otherwise be operably coupled to the implant body 34 soas to be configured to apply energy to the implant body 34 in sufficientquantity that the deformation material 44 deforms in response to theapplied energy. In accordance with the illustrated embodiment, theenergy emitting instrument 70 is a laser, the energy source 74 is alaser source configured to emit energy in the form of a laser beam. Theenergy conduit 76 can define a light pipe that extends from the lasersource, the light pipe configured to communicate the laser beam from thelaser source to the implant 26, and apply the energy in the form of thelaser beam to the implant body 34.

The tensioner 72 can include a first support member 78 configured tosupport the energy conduit 76, and a second support member 80 that isspaced from the first support member along a direction that can beparallel, such as coincident, with the longitudinal axis 38. Inaccordance with the illustrated embodiment, the second support member 80can be spaced from the first support member 78 along the proximaldirection, such that the first support member 78 is disposed between thesecond support member 80 and the bone anchor 26 that receives the energyconduit 76. The second support member 80 is configured to attach to thesuture 28 that extends through at least one of the channels 42 of thebone anchor 26. The tensioner 72 can include a biasing member 82, forinstance a spring such as a coil spring that is connected between thefirst and second support members 78 and 80, respectively. The tensioner72 is configured to bias one of the first and second support members 78and 80, respectively, to move relative to the other of the first andsecond support members 78 and 80, respectively.

During operation, the biasing member 82 applies a force to the secondsupport member 80 that biases the second support member to move alongthe proximal direction away from the bone anchor 26, and also away fromthe first support member 78. Alternatively, the second support member 80can be disposed distal of the first support member 78, and thus betweenthe first support member 78 and the bone anchor 26, such that thebiasing member 82 applies a force to the second support member 80 thatbiases the second support member 80 to move along the proximal directionaway from the bone anchor 26 and toward the first support member 78.

With continuing reference to FIG. 5A, a method of anchoring suture tobone can include the step of inserting the strand of suture 28 into atleast one channel 42 of an initial bone anchor, which can be defined asa first bone anchor 26. In particular, the strand of suture 28 can beinserted into first and second select ones of the channels 42, such thatthe strand of suture 28 extends from the proximal end 36 a, distallyalong the first select one of the channels 42, out the distal end of thefirst select one of the channels 42 as described above, into the distalend of the second select one of the channels 42, proximally along thesecond select one of the channels 42, and out the proximal end 36 a ofthe anchor body. The first and second select channels can be opposedchannels or adjacent channels as described above.

After the strand of suture 28 has been inserted into the at least onechannel 42, the bone anchor 26 can be driven into the bone 24. A pilothole can be drilled or otherwise formed in the bone, and the initialanchor 26 can be driven into the pilot hole, or the anchor 26 can bedriven into the bone without first forming the pilot hole. Next, theenergy conduit 76 is inserted into the insertion aperture 52 orotherwise operably coupled to the anchor body 34. At least one end ofthe strand of suture 28, for instance first and second opposed ends 28 aand 28 b that extend out from different ones of the channels 42 of theinitial bone anchor, can be fixedly attached to the second supportmember 80 prior to deformation of the initial bone anchor.

Referring now to FIG. 5B, the energy source 74 s then actuated so as tocause the energy emitting instrument 70, for instance the energy source74, to emit energy, which can be in the form of a laser beam, to theconduit 76. The energy emitting instrument, for instance at the conduit76, can apply the energy to the bone anchor body 34 so as to cause thedeformation material 44 to deform, thereby causing the anchor body todeform and 1) fix to the bone 24, and 2) capture the strand of suture 28therein with respect to movement relative to the bone anchor 26. Forinstance, the energy emitting instrument, for instance at the conduit76, can apply the energy to the bone anchor body 34 so as to cause thedeformation material 44 to deform and close at least the portion of thechannel 42 that is defined by the deformation material 44, therebycapturing the strand of suture 28 therein with respect to movementrelative to the bone anchor 26. Thus, the strand of suture 28 is unableto move relative to the bone anchor 26 at the portion of the channel 42that has been closed. In accordance with the illustrated embodiment,both channels within which the suture 28 resides can be closed.

It is appreciated that prior to deformation of the first bone anchor,the first bone anchor 26 defines a first length L1 along thelongitudinal axis 38 between the proximal end 36 a and the distal end 36b. As the deformation material 44 deforms, the distal end 36 b can bedrawn toward the proximal end 36 a, thereby shortening the length of thebone anchor to a second length L2 along the longitudinal axis 38 betweenthe proximal end 36 a and the distal end 36 b, wherein the second lengthL2 is greater than L1. For instance, the biasing force of the biasingmember 82 causes the second support member 80, which is attached to thesuture 28, to translate proximally as the deformation material 44 of theanchor body 34 softens and deforms in response to the applied energy,thereby promoting deformation of the anchor body 34 as described above.Furthermore, translation of the second support member 80 can cause thefirst and second ends 28 a and 28 b to likewise translate proximately,thus maintaining a desired level of tension in the strand of suture 28through completion of the application of energy to the anchor body 34and through completion of the resulting deformation. It is furtherappreciated that a maximum width of the anchor body 34 along a directionperpendicular to the longitudinal axis 38 can increase in response todeformation of the deformation material 44, thereby securely anchoringthe bone anchor in the bone 24. It should be appreciated, of course,that the biasing force can be produced by any suitably constructedtensioner 72, or manually, as desired.

Referring now to FIG. 5C, it is appreciated that the first end 28 a isfixed to the initial bone anchor. Accordingly, the first end 28 a can becut at a location adjacent to the proximal end 36 a of the anchor body34, or the first end 28 a can define a free end of the strand of suture28 that extends out from the bone 24. The free end can be looselyattached to the second support member 80, or can be free from the secondsupport member 80. As is described in more detail below, the free endcan be attached to a final one of the bone anchors 26. The second end 28b can then be inserted into first and second select channels of asubsequent bone anchor, which can be define as a second bone anchor 26b, in the manner described above with respect to the first anchor 26 a.The first and second channels 42 can be opposed channels or adjacentchannels as described above. The second end 28 b can extend out theanchor body 34 and can be attached to the second support member 80 inthe manner described above.

After the strand of suture 28 has been inserted into the channels 42 ofthe second bone anchor 26 b, the second bone anchor 26 b can be driveninto the bone 24 in the manner described above. It should be appreciatedthat the second bone anchor 26 can be driven through the soft tissue 22and into the bone 24. Next, as illustrated in FIG. 5D, the method caninclude the step of applying energy to the second bone anchor 26 b so asto cause the deformation material 44 of the second bone anchor 26 b todeform, thereby capturing the strand of suture 28 therein with respectto movement relative to the second bone anchor 26 b. For instance,deforming the deformation material 44 can close the portion of thechannels 42 that is defined by the deformation material 44, therebycapturing the received strand of suture 28 therein with respect tomovement relative to the second bone anchor 26 b. The biasing member 82can apply a biasing force to the second support member 80 that causesthe second support member 80 to move away from both the first supportmember 78 and the first and second bone anchors 26 a and 26 b, therebypromoting deformation and maintaining tension in the strand of suture 28as the length of the second bone anchor 26 b decreases in the mannerdescribed above with respect to the first bone anchor 26 a. It should beappreciated that the strand of suture 28 is continuous, and is fixedlyattached to the first and second bone anchors 26 a and 26 b. Thus, thestrand of suture 28 extends continuously from the first bone anchor 26a, over the bone 24, across the interface 30 between the soft tissue 22and the bone 24, over the soft tissue 22, to the second bone anchor 26b. Because the strand of suture 28 is in tension and is anchored to thefirst and second bone anchors 26 a and 26 b inside the bone 24, thestrand of suture 28 forces the soft tissue 22 into contact with the bone24.

It should be appreciated that the method steps of inserting the strandof suture 28 into at least one such as a pair of channels, driving thebone anchor into the bone, for instance possibly through the soft tissue22 and into the bone 24, and applying the energy to the anchor body canbe sequentially repeated for at least one additional bone anchor, such athird bone anchor 26 c as illustrated in FIG. 6A. For instance, themethod steps of inserting the strand of suture 28 into at least one suchas a pair of channels, driving the bone anchor into the bone, forinstance possibly through the soft tissue 22 and into the bone 24, andapplying the energy to the anchor body can be sequentially repeated fora plurality of additional bone anchors 26 c. In accordance with oneembodiment, the energy is applied to a given one of the bone anchors 26prior to inserting the strand of suture 28 into a channel 42 of anotherone of the bone anchors 26 that is to be subsequently anchored to thebone 24.

As described above, at least one strand of suture can be inserted intothe channels 42 of the anchors 26 prior to driving the anchors into boneand applying the energy to the respective anchor bodies 34. Forinstance, as illustrated in FIG. 6A, a single continuous strand ofsuture 28 can be fixedly attached sequentially to at least two, such asthree, bone anchors 26 a, 26 b, and 26 c. Alternatively, as illustratedin FIG. 6B, it should be appreciated that the steps of inserting astrand of suture into at least one channel of the bone anchors 26 caninclude the step of inserting a pair or more, and thus a plurality, ofstrands of suture 28 into the at least one channel. Accordingly, thestep of applying energy to the implant body causes the anchor body, andthus the anchor, to deform so as to secure each of the plurality ofstrands of suture 28 to the respective anchor body. Deformation of theanchor body can further cause the anchor body to fix to the bone 24, andcan cause the portion of the channels defined by the deformationmaterial to close so as to secure the strands of suture 28 therein withrespect to movement relative to the anchor body. A free end of thesingle strand of suture 28, or of a second strand of suture 28, canextend out the proximal end of the bone anchor 26, and out the bone 24,such that it can be attached to an auxiliary implant, such as a softtissue or bone graft, and then secured to itself or the other strand ofsuture 28, for instance at a knot 29, thereby attaching the auxiliaryimplant to the soft tissue 22 or bone 24.

Referring now to FIGS. 7A-7E in general, it is appreciated that the softtissue fixation assembly 20 can include as many bone anchors 26 asdesired, disposed in any arrangement as desired. For instance, asillustrated in FIG. 7A, the first bone anchor 26 a is shown insertedinto the bone without being driven through the soft tissue 22, and thesecond one anchor 26 b is shown inserted through the soft tissue 22 andinto the bone 24. The first and second bone anchors 26 a and 26 b candefine a row 32 of bone anchors. Referring to FIG. 7B, the plurality ofbone anchors 26 c, in combination with the first and second bone anchors26 a and 26 b can define a pair of rows, such as a first row 32 a and asecond row 32 b. For instance, the row defined by the first and secondbone anchors 26 a and 26 b can define the first row 32 a, and theplurality of bone anchors 26 c can define the second row 32 b that isadjacent the first row 32 a. The strand of suture 28 can extend from thefirst row 32 a to the second row 32 b. For instance, the strand ofsuture 28 can extend through adjacent channels 42 (see FIG. 2D) of oneof the bone anchors, such as the second bone anchor 26 b illustrated inFIG. 7B, so as to extend from the first row 32 a along a columndirection toward the second row 32 b. The strand of suture 28 can thenextend through adjacent channels of a subsequent one of the boneanchors, such as one of the plurality of bone anchors 26 c illustratedin FIG. 7B, so as to extend from the column direction to the rowdirection, for instance along the second row 32 b.

With continuing reference to FIG. 7B, the step of driving a final boneanchor 26 d of the plurality of bone anchors 26 c can include the stepof driving the final bone anchor 26 d into the bone 24 at a locationspaced from the first bone anchor 26 a. Thus, the strand of suture 28 isnot connected directly from the final bone anchor 26 d to the first boneanchor 26 a. Because the strand of suture 28 is not directly connectedbetween the bone anchors 26 of every adjacent pair of bone anchors 26,the arrangement defined by the bone anchors 26 can be referred to as anopen arrangement. As described above, the soft tissue fixation assembly20 can include as many bone anchors as desired, configured in anyarrangement as desired. For instance, the soft tissue fixation assembly20 can define as many rows 32 as desired.

Referring to FIG. 7E, the suture 28 of the soft tissue fixation assembly20 can extend from the second bone anchor 26 b to a first one of theplurality of bone anchors 26 c along the first row 32 a. In accordancewith one embodiment, the strand of suture 28 can be inserted intoopposed channels of the second bone anchor 26 b, wherein the opposedchannels are spaced from each other along a direction that issubstantially parallel with the row 32 a. The suture 28 can extend fromthe second bone anchor 26 b toward a first one of the plurality of boneanchors 26 c. The strand of suture 28 can be inserted into adjacentcolumns of the first one of the plurality of bone anchors 26 c. Thus,the suture 28 can extend from the second bone anchor 26 b along the row32 a to the first one of the plurality of bone anchors 26 c, and along acolumn direction from the first one of the plurality of bone anchors 26c to a second one of the plurality of bone anchors 26 c that lies alongthe second row 32 b. The strand of suture 28 can be inserted intoadjacent columns of the second one of the plurality of bone anchors 26 cso as to extend from the first one of the plurality of bone anchors 26 cto the second one of the plurality of bone anchors 26 c along the columndirection, and along the second row 32 b from the second one of theplurality of bone anchors 26 c to another one of the plurality of boneanchors.

Of course, it should be appreciated that the strand of suture 28 can beinserted into any channels of the bone anchor 26 as desired so as toextend along a respective row 32, or to extend from a respective rowalong the column direction, or to extend from a column direction to arespective row. It should be further appreciated that the soft tissuefixation assembly 20 can define as many bone anchors as desired arrangedalong a given column direction. It should be further appreciated stillthat the soft tissue fixation assembly 20 can define a chainconfiguration having a plurality of rows of bone anchors 26, each rowdefined by two or more bone anchors 26, and the rows of adjacent pairsof rows (thus rows that are partially defined by a common one of theanchors 26) angularly offset from each other at an angle between 90degrees and 180 degrees, or alternatively between 0 degrees and 90degrees (and thus an angle other than 90 degrees). Thus, the firstanchor 26 a can be disposed at a first terminal end of the chain, andthe final bone anchor 26 d can be disposed at a second terminal end ofthe chain.

Referring now to FIG. 7C, the suture 28 can be connected between thefinal bone anchor 26 d and the first bone anchor 26 a. For instance, asdescribed above with reference to FIG. 5C, the first end 28 a of thestrand of suture 28 can define a free end that extends out from thefirst bone anchor 26 a and the bone 24. Similarly, the second end 28 bof the strand of suture 28 can define a free end that extends out fromthe final bone anchor 26 d and the bone 24. The free ends that aredefined by the first and second ends 28 a and 28 b can be attached toeach other in accordance with any suitable embodiment, so as to directlyattach the suture 28 to the last bone anchor 26 d and the first boneanchor 26 a. For instance, the free ends can be tied to each other, orsecure to each other via any suitable fastener. Because the strand ofsuture 28 is directly connected between the bone anchors 26 of everyadjacent pair of bone anchors 26, the arrangement defined by the boneanchors 26 can be referred to as a closed arrangement.

Referring now to FIG. 7D, the bone anchors 26 can define a closedarrangement in accordance with an alternative embodiment. For instance,the plurality of additional bone anchors 26 c can define a select boneanchor 26 e that is driven into the bone 24 and deformed before thefinal bone anchor 26 d is driven into the bone. As described above, thefirst end 28 a of the strand of suture 28 can define a free end thatextends out from the first bone anchor 26 a and the bone 24 as describedabove. Furthermore, the second end 28 b of the strand of suture 28 candefine a free end that extends out from the select bone anchor 26 e andthe bone 24.

The free end defined by the first end 28 a of the strand of suture 28can be inserted into at least one channel of the final bone anchor 26 d.For instance, the free end defined by the first end 28 a of the strandof suture 28 can be inserted into a first channel 42 of the final boneanchor 26 d, and out of a second channel 42 of the final bone anchor 26d. The first and second channels of the final bone anchor 26 d can beadjacent channels or opposed channels as described above. Similarly, thefree end defined by the second end 28 b of the strand of suture 28 canbe inserted into at least one channel of the final bone anchor 26 d. Forinstance, the free end defined by the second end 28 b of the strand ofsuture 28 can be inserted into a first channel 42 of the final boneanchor 26 d, and out of a second channel 42 of the final bone anchor 26d. The first and second channels can be adjacent channels or opposedchannels as described above. In accordance with one embodiment, thefirst channel of the free end that receives the first end 28 a candefine the second channel that receives free end defined by the secondend 28 b. Similarly, the first channel that receives second end 28 b candefine the first channel that receives the first end 28 a. It should beappreciated, of course, that the free ends defined by the first andsecond ends 28 a and 28 b, respectively, can be inserted into differentchannels of the final bone anchor 28 d. In accordance with theembodiment illustrated in FIG. 2D, the first and second bone anchors 26a and 26 b can each be driven through the soft tissue 22 and into thebone 24, and the select and final ones 26 e and 26 d, respectively, ofthe plurality of bone anchors 26 c can be inserted into the bone 24without being driven through the soft tissue 22.

The foregoing description is provided for the purpose of explanation andis not to be construed as limiting the soft tissue fixation system, orcomponents thereof. While various embodiments have been described withreference to preferred embodiments or preferred methods, it isunderstood that the words which have been used herein are words ofdescription and illustration, rather than words of limitation.Furthermore, although the embodiments have been described herein withreference to particular structure, methods, and embodiments, thedisclosure is not intended to be limited to the embodiments specificallydescribed herein. For instance, it should be appreciated that structureand methods described in association with one embodiment are equallyapplicable to all other embodiments described herein unless otherwiseindicated. Those skilled in the relevant art, having the benefit of theteachings of this disclosure, may effect numerous modifications to theembodiments as described herein, and changes may be made withoutdeparting from the scope of the present invention, for instance as setforth by the appended claims.

1. A bone anchor configured to deform in response to an applied energyfrom a laser source, the bone anchor comprising: a bone anchor bodyhaving (1) a proximal end, (2) a distal end that is spaced from theproximal end along a central longitudinal axis, and (3) a perimetersurface that extends from the proximal end to the distal end, the boneanchor body defining at least one channel that extends into theperimeter surface and that is elongate as it extends between theproximal end and the distal end, wherein at least a portion of the boneanchor body comprises a deformation material that defines at least aportion of the perimeter surface and the at least one channel, thedeformation material being responsive to the applied energy from thelaser source so as to deform and capture a strand of suture with respectto movement relative to the bone anchor body when the strand of sutureis received by the at least one channel, and the deformation material isconfigured to prevent the applied energy from the laser source fromtraveling to the distal end.
 2. The bone anchor of claim 1, wherein theat least one channel comprises first and second channels that extendinto the perimeter surface, each being elongate as it extends betweenthe proximal end and the distal end.
 3. The bone anchor of claim 2,wherein the first and second channels are spaced opposite one another.4. The bone anchor of claim 2, wherein the first and second channels areoffset from one another other by an angle of separation of substantially90 degrees.
 5. The bone anchor of claim 2, wherein the first and secondchannels are configured to receive first and second portions,respectively, of the strand of suture, wherein the deformation materialis responsive to the applied energy so as to deform and, when the firstand second portions of the strand of suture are received in the firstand second channels, respectively, close at least a portion of each ofthe first and second channels and capture the first and second portionsof the strand of suture therein with respect to movement relative to thebone anchor body.
 6. The bone anchor of claim 2, wherein each of thefirst and second channels defines a first end, and a second end that isdistal from the first end, and the second ends of the first and secondchannels are open to each other.
 7. The bone anchor of claim 6, whereinthe second ends are open to each other at the distal end of the boneanchor body.
 8. The bone anchor of claim 1, wherein the bone anchordefines a color configured to prevent a laser beam from the laser fromtraveling to the distal end.
 9. The bone anchor of claim 1, wherein thebone anchor is made of a substance that prevents the applied energy fromtraveling to the distal end.
 10. The bone anchor of claim 1, wherein thedeformation material is disposed in a middle region of the anchor bodythat includes a location midway between the proximal and distal ends.11. The bone anchor of claim 1, wherein the bone anchor has an internalsurface that defines an aperture that extends into the proximal endsubstantially along the central longitudinal axis, and the internalsurface is configured to receive a light pipe extending from the lasersource.
 12. A soft tissue fixation system comprising: the bone anchor ofclaim 11; and a laser instrument including the laser source and thelight pipe extending from the laser source, the light pipe configured tobe received in the aperture of the bone anchor and configured to carry alaser beam emitted by the laser source, and apply the laser beam to thebone anchor.
 13. A method of anchoring suture to at least one bone, themethod comprising steps of: inserting at least a portion of a strand ofsuture into at least one channel that extends into an outer perimetersurface of a bone anchor and that is elongate a proximal direction thatextends from a distal end of the bone anchor to a proximal end of thebone anchor such that the portion of the strand of suture extends alongthe at least one channel in the proximal direction and out the proximalend of the bone anchor; driving the distal end of the bone anchor intothe at least one bone in a distal direction, opposite the proximaldirection; applying energy from a laser source to the bone anchor suchthat the energy causes a deformation material that defines at least aportion of the at least one channel to deform and capture the portion ofthe strand of suture with respect to movement relative to the boneanchor, and such that the deformation material prevents the energy fromthe laser source from traveling to the distal end.
 14. The method ofclaim 13, wherein the at least one channel comprises first and secondchannels, and the inserting step comprises inserting at least first andsecond portions of the strand of suture into the first and secondchannels, respectively, such that the first and second portions extendalong the first and second channels, respectively, in the proximaldirection and out the proximal end of the bone anchor.
 15. The method ofclaim 14, wherein the inserting step comprises routing a portion of thesuture from the first channel to the second channel, the first andsecond channels being spaced opposite one another.
 16. The method ofclaim 14, wherein the inserting step comprises routing a portion of thesuture from the first channel to the second channel, the first andsecond channels being offset from one other by an angle of separation ofsubstantially 90 degrees.
 17. The method of claim 13, wherein theapplying step comprises applying the energy such that a color defined bythe bone anchor prevents the energy from the laser source from travelingto the distal end.
 18. The method of claim 13, wherein the applying stepcomprises applying the energy such that a substance that forms the boneanchor prevents the applied energy from traveling to the distal end. 19.The method of claim 13, comprising inserting a light pipe that extendsfrom the laser source into an aperture that extends into the proximalend of the bone anchor, and the applying energy step comprises causingthe laser source to emit a laser beam along the light pipe to the boneanchor.
 20. The method of claim 13, wherein the applying step comprisescausing the distal end of the bone anchor to be drawn towards theproximal end of the bone anchor as the deformation material deforms,thereby shortening an overall length of the bone anchor from its distalend to its proximal end.